瑞舒伐他汀、普伐他汀对轻中度原发性高血压患者冠状动脉粥样硬化的影响

The Effect of Rosuvastatin and Pravastatin on Coronary Artery Plaque in Essential Hypertension

目的评价瑞舒伐他汀对轻中度原发性高血压(EH)患者冠状动脉粥样硬化的影响,观察常规剂量、不同的他汀药物对轻中度EH合并冠状动脉硬化的早期干预作用。方法将68例(男40例,女28例)经双源螺旋CT血管造影(DSCTA)检查诊断并经过冠状动脉造影确诊的冠状动脉粥样斑块患者,随机分为瑞舒伐他汀(10 mg/d,n=34)组和普伐他汀(20 mg/d,n=34)组,1月复查总胆固醇、低密度脂蛋白胆固醇(LDL-C)不达标者剂量加倍,12月后复查DSCTA观察斑块变化。结果治疗12月后两组LDL-C、总胆固醇均较治疗前降低且瑞舒伐他汀组下降更显著(P<0.05)。治疗前后斑块引起的冠脉狭窄下降幅度为软斑块>纤维斑块>混合斑块>钙化斑块,且瑞舒伐他汀组下降更明显(P<0.05)。结论瑞舒伐他汀可有效降低胆固醇,能明显逆转冠脉粥样斑块,降低冠脉狭窄程度。

Objective To evaluate the effect of rosuvastatin on coronary artery plaque.Methods Sixty-eight patients with coronary artery atheromatous plaque were examined with dual source spiral CT and randomly divided into two groups：the treatment group receiving rosuvastatin 10 mg/d and the control group given pravastatin 20 mg/d for a continuous period of 12 months respectively.The changes of plaque and blood lipid were observed before and after the treatment.Results The TC and LDL-C of the treatment group were more significantly reduced than those of the control group（39.2% and 52.3% respectively,P0.05）.The coronary artery stenosis caused by all plaques decreased to various degrees after the treatment： 26% decrease in lipoid plaques（P〈0.01）,19% in fibrous plaques（P〈0.05）,16% in mixed plaques（P〈0.05）,3.5% in calcified plaques（P〉0.05）.The treatment group induced greater reduction in comparison with the control group（P〈0.05）.Conclusion Rosuvastatin can effectively reduce blood lipid markedly,reverse and stabilize the coronary artery plaque.